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SBFP Form 1 (2020)
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Department of Education
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Region ___
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Master List Beneficiaries for School-Based Feeding Program (SBFP) (SY________)
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Division/Province: ______________________________________
Name of Principal : ____________________________________
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City/ Municipality/Barangay : ____________________________
Name of Feeding Focal Person : _________________________
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Name of School / School District : _________________________
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School ID Number: _________________________
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No.NameSexGrade/ SectionDate of Birth (MM/DD/YYYY)Date of Weighing / Measuring (MM/DD/YYYY)Age in Years / MonthsWeight (Kg)Height (cm)BMI for 6 y.o. and aboveNutritional Status (NS)Dewormed? (yes or no)Parent's consent for milk? (yes or no)Participation in 4Ps (yes or no)Beneficiary of SBFP in Previous Years (yes or no)
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BMI-AHFA
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Prepared by:
Approved by:
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__________________________________
School Head
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Feeding Focal Person
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Note: This form shall be prepared by the school before the start of feeding to be compiled by the SDO.
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